Research Article

Xm2 Scores for Estimating Total Exposure to Multimodal Strategies Identified by Pharmacists for Managing Pain: Validity Testing and Clinical Relevance

Table 2

Number of individuals using each pain management strategy identified in the study organized by low or high Xm2 score and maximum Xm2 score for each strategy.

Pain management strategyIndividuals using each strategy N (%)Maximum Xm2 score
Total (n = 149)Low Xm2 score (<16 points) (n = 73)High Xm2 score (≥16 points) (n = 76)

Prescription medications
 Use of an opioid49 (32.9)113815
  Codeine3 (2.0)122
  Fentanyl1 (0.7)011
  Hydrocodone26 (17.4)5216
  Hydromorphone1 (0.7)017
  Methadone1 (0.7)0113
  Morphine2 (1.3)0213
  Oxycodone13 (8.7)21115
  Tramadol11 (7.4)383
 Use of a nonopioid125 (83.9)51749
  Analgesics
   Acetaminophen36 (24.2)6303
   Dichloralphenazone1 (0.7)012
  Anticonvulsants
   Carbamazepine1 (0.7)103
   Gabapentin17 (11.4)5124
   Lamotrigine1 (0.7)012
   Levetiracetam1 (0.7)013
   Pregabalin2 (1.3)202
   Topiramate3 (2.0)032
   Valproic acid1 (0.7)013
  Antidepressants
   Amitriptyline8 (5.4)267
   Bupropion1 (0.7)012
   Duloxetine12 (8.1)1119
   Fluoxetine1 (0.7)013
   Mirtazapine1 (0.7)012
   Nortriptyline4 (2.7)044
   Sertraline2 (1.3)023
   Trazodone2 (1.3)022
   Venlafaxine4 (2.7)046
   Vilazodone1 (0.7)015
  Antipsychotic
   Quetiapine1 (0.7)011
  Barbiturate
   Butalbital3 (2.0)035
  Beta blockers
   Atenolol1 (0.7)013
   Metoprolol3 (2.0)032
   Propanolol3 (2.0)034
  Calcium channel blockers
   Amlodipine1 (0.7)015
   Verapamil1 (0.7)013
  Muscle relaxants
   Baclofen1 (0.7)012
   Carisoprodol9 (6.0)185
   Chlorzoxazone1 (0.7)012
   Cyclobenzaprine29 (19.5)5249
   Metaxalone4 (2.7)044
   Methocarbamol6 (4.0)152
   Orphenadrine1 (0.7)013
   Tizanidine3 (2.0)031
  Nonsteroidal anti-inflammatory drugs
   Celecoxib9 (6.0)095
   Diclofenac7 (4.7)165
   Etodolac2 (1.3)115
   Ibuprofen58 (38.9)27314
   Indomethacin2 (1.3)022
   Meloxicam12 (8.1)1115
   Nabumetone4 (2.7)134
   Naproxen37 (24.8)13244
   Salsalate2 (1.3)022
   Sulindac1 (0.7)103
   Tolmetin1 (0.7)013
  Sedatives
   Alprazolam1 (0.7)011
   Diazepam1 (0.7)013
   Lorazepam2 (1.3)021
  Steroids
   Methylprednisolone1 (0.7)011
   Prednisolone1 (0.7)011
  Triptans
   Eletriptan3 (2.0)033
   Naratriptan1 (0.7)013
   Rizatriptan4 (2.7)132
   Sumatriptan5 (3.4)053
   Zolmitriptan2 (1.3)113
  Others
   Caffeine3 (2.0)031
   Isometheptene1 (0.7)012
Nonprescription medications
 Acetaminophen64 (43.0)28361
 Aspirin16 (10.7)881
 Benadryl1 (0.7)011
 Excedrin2 (1.3)111
 Famotidine1 (0.7)011
 Herbals16 (10.7)791
 NSAIDs95 (63.8)48471
 Supplement11 (7.4)381
Medical strategies
 Chiropractor32 (21.5)12201
 Nasal spray1 (0.7)011
 Other injections1 (0.7)011
 Patch2 (1.3)021
 Surgery31 (20.8)5261
 Steroid injections50 (33.6)10401
 Topical products15 (10.1)5101
Physical strategies
 Acupuncture21 (14.1)6151
 Massage92 (61.7)39531
 Physical activity105 (70.5)44611
 Physical therapy81 (54.4)27541
 Stretching5 (3.4)501
 TENS51 (34.2)14371
Psychological strategies
 Meditation42 (28.2)12301
 Relaxation89 (59.7)31581
Self-initiated strategies
 Alcohol1 (0.7)101
 Avoid specific activities104 (69.8)43611
 Cannabis/Heroin3 (2.0)031
 Changing body position132 (88.6)61711
 Diet3 (2.0)211
 Education38 (25.5)12261
 Essential oils1 (0.7)011
 Hot bath or shower96 (64.4)39571
 Hot or cold packs99 (66.4)36631
 Rest125 (83.9)56691
 Unspecified59 (39.6)27321

TENS = transcutaneous electrical nerve stimulation. The minimum score is 0 in all cases. Indicates the strategy was also identified in the literature. An Xm2 score of 5 indicates that item is being used at 100 to 124% of the recommended maximum exposure (RME).